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General NPI Number Information
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NPI Number | 1669496899
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Entity Type | Individual
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Provider Name | FREDRICA JILL GOVER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 611 S PALM CANYON DR SUITE 201
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City | PALM SPRINGS
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State | CA
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Zip | 92264-7213
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Country | US
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Telephone | 760-416-7899
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Fax | 760-416-7786
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Provider Business Mailing Address
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Address Line | 1835 N. VIA MIRALESTE #1618
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City | PALM SPRINGS
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State | CA
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Zip | 92262
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Country | US
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Telephone | 760-832-9631
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Fax | 760-832-9631
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 13880
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY13880
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License Number State | CA
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